Staged mini-open lateral-anterior lumbar interbody fusion combined with posterior instrumentation via Wilste approach: an alternative minimally invasive treatment strategy for adult degenerative scoliosis
10.3760/cma.j.cn121113-20240225-00112
- VernacularTitle:侧前路腰椎椎间融合联合后方肌间隙入路内固定分期手术治疗退变性脊柱侧凸
- Author:
Zhaomin ZHENG
1
;
Huafeng ZHANG
;
Jianru WANG
Author Information
1. 中山大学附属第一医院脊柱外科，广州 510080
- Keywords:
Lumbar vertebrae;
Intervertebral disc degeneration;
Scoliosis;
Minimally invasive surgical procedures
- From:
Chinese Journal of Orthopaedics
2024;44(11):724-729
- CountryChina
- Language:Chinese
-
Abstract:
With the aging of the population, the number of patients with degenerative scoliosis continues to increase. Surgical treatment of degenerative scoliosis is challenging. Patients with degenerative scoliosis often present with multiple comorbidities, osteoporosis, and sarcopenia. Traditional open surgeries are associated with high risks and multiple complications, whereas minimally invasive surgeries have increasingly gained acceptance among patients and physicians. Lateral Lumbar Interbody Fusion (LLIF) offers advantages such as minimal trauma, less blood loss, rapid postoperative recovery, reduced risk of neural complications, and larger interbody cages with more grafting capacity. Mini-open lateral-anterior lumbar interbody fusion is a new standardized LLIF technique with smaller incisions, which does not require splitting the psoas muscle, thereby reducing the risk of muscle and nerve injuries, and involves vertical implantation of the fusion device. Posterior instrumentation via the Wiltse approach is characterized by shorter operational times, minimal radiation exposure, reduced muscular damage, increased graft fusion capabilities, and the ability to perform de-rotation maneuvers. Therefore, the Wiltse approach is particularly suitable for patients with degenerative scoliosis. Staged surgery significantly reduces the duration of each surgery and anesthesia, lowering surgical risks and enhancing postoperative recovery. Staged mini-open lateral-anterior lumbar interbody fusion and posterior instrumentation via the Wiltse approach maximizes the reduction of surgical trauma, significantly decreases surgical complications, and offers marked clinical outcomes, providing an alternative minimally invasive treatment for degenerative scoliosis.
